Urinary Incontinence

Question 1

Stress UI

Answer 1

Occurs with increased in intra-abdominal pressure

Question 2

Urge UI

Answer 2

May be preceded by a sense of urinary urgency

Question 3

Mixed UI

Answer 3

Combination of urge and stress

Question 4

Overflow UI

Answer 4

Overextended bladder due to impaired destrusor contractility and/or bladder obstruction

Question 5

Functional UI

Answer 5

Environmental or physical barriers to toileting

Question 6

52 y/o female with 3 children (vaginally delivered) who presents with complaints of urinary incontinence with coughing and exercise. She reports that it started 4 years prior but has
increasingly worsened and it’s now taking a toll on her QoL.

Which is the following types of UI is Cinderella experiencing?
A. Stress incontinence
B. Urge incontinence
C. Overflow incontinence
D. Functional incontinence
E. Mixed

Answer 6

A. Stress incontinence

Question 7

List some medication classes that can exacerbate UI

Answer 7

.Alpha blockers
.Anticholinergics
.CCBs
.Diuretics
.Hormone therapy

Question 8

Cinderella has a PMH of hypertension, depression, seasonal
allergies, and difficulty sleeping. FH: noncontributory. SH: 1 glass
of wine daily with dinner. Meds: Sertraline 25mg qd, Amlodipine 10mg qd, Benadryl 25mg prn hs

Which of the following medications/conditions are contributing
to Cinderella’s UI?
A. Use of CCBs
B. Depression/use of antidepressants
C. Alcohol use
D. Use of diphenhydramine
E. All of the above

Answer 8

E. All of the above

Question 9

First, second and third line therapy options

Answer 9

First: Behavioral therapy
Second: Antimuscarinics (darifenacin, oxybutynin, etc.)
Third: Neuromodulation or Botox therapy (not FDA approved)

Question 10

Anticholinergic MOA and side effects

Answer 10

MOA: binds M3 receptors to prevent ACh from binding
AE: dizziness, drowsiness, confusion, dry mouth/eyes, constipation, urinary retention

Question 11

Oxybutynin CI

Answer 11

Contraindicated in uncontrolled narrow angle glaucoma

Question 12

Beta 3 agonist MOA and adverse effects

Answer 12

MOA: binds to beta 3 leading to detrusor smooth muscle relaxation
AE: HTN, tachycardia, dry mouth, UTIs, arthralgia, angioedema

Question 13

Botox black box warning

Answer 13

Injection may become systemic (SOB)

Question 14

Cinderella comes back 6 years later with urge incontinence and is started on oxybutynin XL 5mg daily. She comes back to clinic 3 months later with complains of dry mouth, and some dry
eyes.

Which of the following options would be an appropriate way to manage Cinderella’s
symptoms?
A. Switch to IR formulation
B. Start artificial tears and docusate
C. Switch to the patch
D. Continue therapy, it will go away after 6 months

Answer 14

C. Switch to the patch